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Updated: Aug 22, 2025

Author Spotlight: Workflow for Integrating POCUS Data into EHR for Managing Heart Failure Patients
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Design and Implementation of a Cloud PACS Architecture.

Jacek Kawa1,2, Bartłomiej Pyciński2, Michał Smoliński1

  • 1Radpoint Sp. z o.o., Ceglana 35, 40-514 Katowice, Poland.

Sensors (Basel, Switzerland)
|November 11, 2022
PubMed
Summary

This study presents a novel cloud-native Picture Archiving and Communication System (PACS) architecture, overcoming limitations of traditional systems. The cloud PACS demonstrated enhanced scalability and performance compared to monolithic servers.

Keywords:
cloudcloud storagemedical imagingpicture archiving and communication systemvendor neutral archive

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Area of Science:

  • Medical Imaging Informatics
  • Cloud Computing in Healthcare
  • Health IT Systems

Background:

  • Traditional Picture Archiving and Communication Systems (PACS) face challenges with backward compatibility, security, and maintenance.
  • Existing cloud-based solutions have not fully realized a cloud-native PACS architecture.
  • Limitations in legacy PACS hinder efficient medical image management and data accessibility.

Purpose of the Study:

  • To introduce and evaluate a novel, vendor-neutral, cloud-native PACS architecture.
  • To demonstrate the feasibility and performance of a full-scale cloud-native PACS.
  • To address the limitations of classic PACS through a modern, scalable cloud solution.

Main Methods:

  • Developed a two-component architecture: a multi-tenant cloud platform for archiving and management, and an access device for local DICOM interface.
  • Implemented the cloud PACS on Amazon Web Services using services like Kafka, OpenSearch, and Memcached, alongside custom microservices.
  • Verified the system with diverse medical imaging data (CT, MR, CR) and compared its scaling behavior against a monolithic server.

Main Results:

  • The cloud PACS reliably stored and accessed medical image data from various modalities.
  • The proposed cloud PACS showed significantly improved performance and scalability with increasing parallel connections compared to a monolithic server.
  • Evaluated retrieval patterns confirmed the system's adaptability to different usage scenarios.

Conclusions:

  • The demonstrated cloud-native PACS architecture offers a viable, scalable, and high-performance alternative to traditional PACS.
  • This approach effectively addresses the security, maintenance, and scalability issues inherent in classic PACS.
  • The multi-tenant cloud platform and microservices architecture provide a robust foundation for future medical imaging data management.